Examining the Development of Acute Tolerance to Subjective Response to Alcohol in an Alcohol Administration Study

Both subjective response to alcohol and acute tolerance possess unique biphasic relations with the blood alcohol concentration curve. However, prior work has generally failed to examine shared relations between the two constructs and has yet to consider the full valence by arousal affective space of subjective response, nor individual differences in metabolism or peak levels of subjective intoxication. As such, the present study sought to characterize acute tolerance to subjective response in addition to examining relations between acute tolerance, subjective response, and related outcomes. Participants (N=258) were randomly assigned to receive alcohol (target blood alcohol concentration = .08 g%) as part of a large placebo-controlled alcohol administration study. Participant family history of alcohol use problems and personal history of alcohol use were collected at baseline. Subjective response to alcohol was assessed across the full valence by arousal affective space at equivalent points on the ascending and descending limbs of the blood alcohol concentration curve. Latent change scores were calculated to characterize the development of acute tolerance, and path analyses tested relations between acute tolerance to subjective response, concurrent patterns of alcohol use, and negative alcohol-related consequences. Age, sex, race/ethnicity, and drinking context were included as covariates. Acute tolerance to low arousal positive (i.e., relaxed, mellow) effects were found to be inversely related to negative consequences such that a maintenance of low arousal positive effects was associated with more negative consequences. The amount of time elapsed between measurements was found to be significantly related to the development of acute tolerance to high arousal positive (i.e., talkative, stimulated) effects, such that more time between measurements was related to a greater decrease in high arousal positive effects. Peak high arousal positive effects were found to be related to increased drinking and indirectly related to more negative consequences via drinking, whereas high arousal negative was protective against increased drinking and negative consequences. Results suggest that a maintenance of negatively reinforcing effects across the blood alcohol concentration curve may confer risk for negative consequences. Results also suggest that considering individual differences in alcohol metabolism may be useful in understanding alcohol’s rewarding, stimulating effects.